TB and alcoholism

HE has been up and down for the most part of his life. A beacon of hope when fit and when down one would always wish if God could do His will. Such has been the life of Timothy Vakai who was diagnosed of TB when he was in Form 3 more than two decades ago.

His parents had to withdraw him from boarding school so that they could monitor his health. But as time passed by peer pressure got into him. Like many of his peers he would take alcohol. And this saw him sick some times and whenever he would feel fit Timothy would resort to drinking again.

Unlike some patients who have no one to support them on their treatment journey, Timothy had all the support he needed from the medical doctors, family and even his neighbours.

“Timothy would take more of alcohol than his TB medication as he would usually forget to take his pills, sometimes vomit them and he would not listen to anyone including the doctors.

“My brother had always been a drunkard but doctors advised him to stop smoking and drinking at least during the treatment period when he was diagnosed of TB,” narrated his brother Terence Vakai when we visited his homestead in Kadoma’s mining are of Golden Valley.

Vakai said his brother never had to deal with the stigma and isolation that is often attached to TB especially in rural areas due to the support he was getting from the people who were around him.

He said Timothy had adequate information on treatment and management of TB and the village health worker in the area would visit and provide pamphlets with information needed to ensure the brother does not default.

“My brother knew that TB was treatable, for free and that he only needed a few months of consistent medicine uptake to beat the disease,” he said.

He then urged those on treatment to religiously take their medication and follow medical advice saying combined efforts between government and other stakeholders will help reduce the burden.

“We cannot leave everything to the doctors, we, as the public, need to play our part in fighting TB. It is a shared responsibility and attitude matters when one is on treatment,” he said.

He eventually died five months ago.

Community Working Group on Health Executive Director Itai Rusike said due to the general increase of alcohol abuse in the country there is need for those caring for TB patients to monitor alcohol intake for those on treatment.

“The general public and those caring for TB patients should be concerned with alcohol demand reduction, alcohol supply reduction and mitigating the health and social consequences of alcohol use, with the major focus being on demand reduction,” he said.

A medical expert also said alcohol can suppress the immune system, complicate TB treatment since many TB medications have the potential to damage the liver and those who take alcohol often forget to take their medication thereby failing to adhere to their TB treatment.

He said there was need to integrate treatment for alcoholism into the primary care of TB patients suffering from both diseases to reduce public health implications attached to failure to deal with TB and alcoholism.

According to the World Health Organisation (WHO), harmful use of alcohol increases the risk of TB threefold and is also a strong risk factor for poor TB treatment adherence.

Government with the support of International Union on Tuberculosis and Lung Diseases (The Union) have also identified alcohol abusers as a key population for TB as their behaviour exposes them to TB infection.

The Union Country Director Dr Christopher Zishiri said alcohol misuse may impair successful medical treatment as most individuals fail to adhere to treatment requirements, leading to either morbidity or development of the drug resistance strain.

“The Union through the targeted screening for TB among high risk communities (TaS 4TB) project prioritizes such individuals for screening, diagnosis and prompt initiation on appropriate treatment,” he said.

“In addition, we have also invested significantly in the training and mentorship of health care workers to improve the quality of TB services provided to these key populations.”

The WHO suggest that more than 4, 3 million cases of TB go unreported with some receiving no care at all while others accessing poor quality services. The health body further asserts that poor housing, poverty, malnutrition and other various risk factors such as HIV, tobacco use, diabetes, involvement in mining activities and alcohol abuse exposes people to TB.

WHO also recommends countries to identify problem drinkers, diagnose alcohol use disorder, and refer for appropriate alcohol interventions as part of comprehensive treatment package.